The family of a diabetic man are to meet health officials after he died following failures by medical staff and the later falsification of his records.

David Joseph, 80, was admitted to Aberystwyth's Bronglais Hospital in December 2008. He died in April 2009.

The monitoring failures contributed to his hypoglycaemic attack and he later suffered a heart attack.

Wales public services ombudsman Peter Tyndall found failures by the hospital, which is run by Hywel Dda Health Board.

Mr Tyndall, who gave his ruling in April, raised concerns over clinical record keeping at Hywel Dda and made recommendations.

The family is hoping for answers at the meeting with Hywel Dda chief executive Trevor Purt.

They have already met Health Minister Lesley Griffiths and health inspector Dr Peter Higson with the support of charity Diabetes UK.

I don't understand how a patient's blood glucose could have gone down to 1.3 in a medical wardMavis Joseph, David Joseph's widow

"We would like to make sure the treatment of diabetes is up to standard, and it wasn't in my husband's case," said Mavis Joseph, 87, from Aberaeron.

"I've worked in acute medicine. Diabetes is a common complaint and it's getting much more common.

"I don't understand how a patient's blood glucose could have gone down to 1.3 in a medical ward. Six or seven is normal and four is hypoglycaemic.

"It was so unnecessary. He didn't go in because of his diabetes, he went in with an infection."

Held to account

Mr Joseph's daughter, Rowena Jones, made the original complaint to the ombudsman after keeping a photocopy of her father's medical records.

She said: "We want to see the chief executive because we want to ensure the recommendations of the ombudsman's report are fulfilled and we don't have an enormous amount of confidence they will be.

REPORT SUMMARY

The hospital did not record and act upon important details about the patient's diabetic regime and failed to monitor his blood sugar levels properly

The hypoglycaemic attack, to which the hospital's failings contributed, had an unspecific causal effect on the patient's subsequent cardiac arrest and deterioration

There appeared to be a deliberate attempt to cover up the lack of blood sugar monitoring

The internal complaint investigations before the Ombudsman's involvement were inadequate

Source: Public services ombudsman

"There's the issue of diabetes, the issue of the complaints procedure and how it was handled, and the issue of tampering with medical records.

"Nobody has been held to account and I'm not sure there will be closure if nobody is being held to account for what happened.

"It started off very much as personal thing about our father's death and what happened to him, and I think the more we have learnt investigating it over the past three years the more we have come to realise that the standard of care for diabetics in Wales is below par."

She also wants the health board and other boards to adopt the "think glucose" package which is an NHS Institute programme designed to support hospital trusts to improve the management of in-patients with diabetes as a secondary diagnosis.

"The more we have looked at it the more we have realised diabetes care for all of Wales is poor," she added.

'Worrying spotlight'

The family are to hand a cheque for £1,700 they received in compensation from the health board to Diabetes UK Cymru.

The charity's national director Dai Williams said: "This tragic case throws a worrying spotlight on the poor state of inpatient care for people in Wales with diabetes".

Following the ombudsman's report in April, Hywel Dda Health Board director of nursing and midwifery Caroline Oakley apologised to the patient's family for care that "fell below the standards expected".

She said that since the incident in 2008 a number of measures had been put in place, including more training for diabetes nurses and a review of blood monitoring equipment.

Ms Oakley said the board was committed to improvements. All nursing staff have also been reminded of the professional standards expected of them.